Atrophoderma of Pasini and Pierini Treatment & Management
- Author: Sarah Jane Adams, MD; Chief Editor: Dirk M Elston, MD more...
No treatment is consistently effective, but some patients respond to topical corticosteroids, antibiotics, or antimalarials.
Results of medical treatment with antibiotics have been inconclusive. In patients with new early-stage idiopathic atrophoderma of Pasini and Pierini, especially those with a positive B burgdorferi antibody titer, the standard recommended therapy for Lyme disease is suggested. A retrospective evaluation of 25 patients treated with oral penicillin (2 million IU/d) or oral tetracycline (500 mg 3 times/d) for 2-3 weeks showed clinical improvement with no new active lesions in 20 patients. The same study also showed no progressive disease in 4 of 6 patients who did not receive treatment.
A report of a 35-year-old woman with elevated B burgdorferi antibody (IgM) titer and atrophoderma of Pasini and Pierini describes clinical improvement with no new lesions with doxycycline (200 mg/d) for 6 weeks.
Anecdotal reports have described beneficial treatment with the use of hydroxychloroquine and potassium aminobenzoate.
Surgical treatment has generally not been helpful in improving the appearance of the atrophied skin.
Arpey et al showed the Q-switched alexandrite laser (755 nm) to be effective in diminishing the hyperpigmentation by 50% after 3 treatments in one case.
Idiopathic atrophoderma of Pasini and Pierini is typically a benign, asymptomatic condition; no complications have been reported.
Once the diagnosis is established, outpatient care consists of following up for the development of new lesions and the involvement of new areas. Ultrasonography may be used for diagnosis and follow-up.
Pasini A. Atrofodermia idiopatica progressiva. G Ital Dermatol. 1923. 58:785.
Pierini L, Vivoli D. Atrofodermia progressiva (Pasini). G Ital Dermatol. 1936. 77:403-09.
Canizares O, Sachs PM, Jaimovich L, Torres VM. Idiopathic atrophoderma of Pasini and Pierini. AMA Arch Derm. 1958 Jan. 77(1):42-58; discussion 58-60. [Medline].
Yokoyama Y, Akimoto S, Ishikawa O. Disaccharide analysis of skin glycosaminoglycans in atrophoderma of Pasini and Pierini. Clin Exp Dermatol. 2000 Jul. 25(5):436-40. [Medline].
Kim SK, Rhee Sh, Kim YC, Lee ES, Kang HY. Congenital atrophoderma of Pasini and Pierini. J Korean Med Sci. Feb 2006. 21(1):169-71. [Medline].
Handler MZ, Alshaiji JM, Shiman MI, Elgart GW, Schachner LA. Congenital idiopathic atrophoderma of Pasini and Pierini. Dermatol Online J. 2012 Apr 15. 18(4):4. [Medline].
Avancini J, Valente NY, Romiti R. Generalized lenticular atrophoderma of Pasini and Pierini. Pediatr Dermatol. 2015 May-Jun. 32 (3):389-91. [Medline].
Saleh Z, Abbas O, Dahdah MJ, Kibbi AG, Zaynoun S, Ghosn S. Atrophoderma of Pasini and Pierini: a clinical and histopathological study. J Cutan Pathol. 2008 Dec. 35(12):1108-14. [Medline].
Miteva L, Kadurina M. Unilateral idiopathic atrophoderma of Pasini and Pierini. Int J Dermatol. Nov 2006. 45(11):1391-3. [Medline].
Buechner SA, Rufli T. Atrophoderma of Pasini and Pierini. Clinical and histopathologic findings and antibodies to Borrelia burgdorferi in thirty-four patients. J Am Acad Dermatol. 1994 Mar. 30 (3):441-6. [Medline].
Lis-Święty A, Bierzyńska-Macyszyn G, Arasiewicz H, Brzezińska-Wcisło L. Bilateral atrophoderma linearis: a relationship between atrophoderma linearis Moulin and atrophoderma Pasini-Pierini?. Int J Dermatol. 2016 Mar. 55 (3):339-41. [Medline]. [Full Text].
Batista CM, Lemos MO, Franceschi LE, Basilio CB, Reis CM. Case for diagnosis. An Bras Dermatol. 2014 Jul-Aug. 89 (4):671-3. [Medline].
Kopec-Medrek M, Kotulska A, Zycinska-Debska E, Widuchowska M, Kucharz EJ. Exacerbated course of atrophoderma of Pasini and Pierini in patient with papillary cancer of the thyroid gland. Wiad Lek. 2010. 63(1):24-6. [Medline].
Abe I, Ochiai T, Kawamura A, Muto R, Hirano Y, Ogawa M. Progressive idiopathic atrophoderma of Pasini and Pierini: the evaluation of cutaneous atrophy by 13-MHz B-mode ultrasound scanning method. Clin Exp Dermatol. 2006 May. 31(3):462-4. [Medline].
Berman A, Berman GD, Winkelmann RK. Atrophoderma (Pasini-Pierini). Findings on direct immunofluorescent, monoclonal antibody, and ultrastructural studies. Int J Dermatol. 1988 Sep. 27 (7):487-90. [Medline].
Kernohan NM, Stankler L, Sewell HF. Atrophoderma of Pasini and Pierini. An immunopathologic case study. Am J Clin Pathol. 1992 Jan. 97(1):63-8. [Medline].
Lee Y, Oh Y, Ahn SY, Park HY, Choi EH. A Case of Atrophoderma of Pasini and Pierini Associated with Borrelia burgdorferi Infection Successfully Treated with Oral Doxycycline. Ann Dermatol. 2011 Aug. 23(3):352-6. [Medline]. [Full Text].
Carter JD, Valeriano J, Vasey FB. Hydroxychloroquine as a treatment for atrophoderma of Pasini and Pierini. Int J Dermatol. 2006 Oct. 45(10):1255-6. [Medline].
Arpey CJ, Patel DS, Stone MS, Qiang-Shao J, Moore KC. Treatment of atrophoderma of Pasini and Pierini-associated hyperpigmentation with the Q-switched alexandrite laser: a clinical, histologic, and ultrastructural appraisal. Lasers Surg Med. 2000. 27(3):206-12. [Medline].
Jeanselme E, Burnier R. Sclerodermie en plaques avec dyschromie pigmentaire symmetrique. Bull Soc Fr Dermatol Syph. 1926. 33:704-06.
Per M. Oberflachliche, circumscripta Sclerodermie. Handbuch. 1931. 8:893.